Distribution of skeletal trauma in children treated at Muhimbili Orthopaedic Institute

Abstract

ABSTRACT Background: Children are vulnerable to trauma because they are unable to recognize and avoid many Potential risks on their own. Paediatric trauma has become a major public health problem and common cause of morbidity and mortality worldwide(4)(5)(6). Objectives: To explore the distribution of skeletal trauma in children treated at MOI. Methodology: A prospective descriptive study done on patients aged from 0 to 17 years. This study was conducted at MOI from July 2017 to April 2018. Three hundred and fifty four patients met the inclusion criteria and were recruited after signing the informed consent. Data was collected using guided structured questionnaire. The obtained data were analyzed by SPSS version 23. Results: During this study a total of 354 children with skeletal trauma were enrolled. Of these 354, male were 245(69.2%) and female 109(30.8%), with approximated male to female ratio of 2:1. The majority were in the school age group of 7-12 years,(35.9% ), followed by preschool age group of 3-5 years (31.1%), adolescent age group of 13-17years and the minority were in the infant and toddler age group of 0-2 years(11.4%.). Majority 286(80.8%) of the victims came from Dar es salaam city and 68(19.2%) from other regions. Falls 226(63.8%) ware the commonest cause of the trauma, followed by road traffic crashes 96(27.1%) of which motorcycle crushes were 45(46.9%), automobile crushes were 45(46.9%) and bicycle crushes were 6(6.3%). Pedestrians 51(52.0%) and passengers 38(38.8%) were the commonest victims of road traffic crushes. Home environments 219(61.9%) were the commonest place of the injury, followed by Roads 94(26.6%). Others, were play grounds 31(8.8%) and school 10(2.8%). The most injured site were the thigh 110(31.1%) that involved the femur, followed by arm that involved the humerus 80(22.6%) forearm 72(20.3%) and the leg that involved the two bones T/F 39(11.0%) . Joints were 11(3.1%) and it was found that large joint outnumbered the small joints. The least site was the spine (0.8%). Fracture was the most form of skeletal trauma encountered 351(95.9%) followed by dislocation 8(2.2%) and fracture-dislocation 7(1.9%) Conclusion: Skeletal trauma in children is a major public health problem and age group of 7 – 12 years was the main group affected. Fracture appeared the most form of skeletal trauma in children, mostly caused by falls in domestic environment, and motor traffic crashes. Pedestrians and passengers are the commonest victims of road traffic crushes Recommendation: Since most causes of skeletal trauma in children are falls (mostly domestic) and traffic crashes, awareness and communication on the magnitude of the problem and education on the risk factors have to be conveyed to community. Preventive measures to motor traffic crashes require the participation of people both at community and national level.